My brother-in-law is a pharmacist.
I was having lunch with him the other day, and we were talking about his new job. He was a retail pharmacist - the guy that fills your prescription at the drugstore - but didn't care for the odd hours and hectic retail environment, so he switched to working for a medical insurance company.
What he does now is approve drugs for treatments of patients. If a doctor wants to prescribe a drug for a patient that normally isn't covered by the insurance company, it goes thru him - and he deciedes whether to cover it or not.
So of course, I got to ask him about Byetta, and he was telling me that it has been working extremely well for diabetics, but he doesn't cover it for obesity - yet. He also mentioned that Byetta's method of injection, by the so-called "Pen" injector is also a very promising technology, especially for those reluctant to take a drug because they would have to inject it. The pen is a very thin, small needle used for injection that produces very little, if any discomfort.
He also mentioned that Pfizer's new inhalable insulin, Exubera, is a dud; not in efficacy, so much as cost. This drug was developed specifically for those diabetics that resist taking the insulin because of the discomfort of the needle. Thing is, it's wildly expensive, compared to ordinary insulin shots, so he's having a hard time OK'ing it for coverage. One would think that someone would use the pen technology that Byetta uses for insulin. Maybe insulin is too thick to use.
Wednesday, March 29, 2006
Accomplia vs. Byetta
Which one might make a better ally in weight loss?
Byetta has been showing great promise for the treatment of type 2 diabetics; I get letters all the time from people telling me how their once untameable sugar levels are now in the normal zone, how they feel much better,etc.
How is Byetta stacking up as a weight-loss drug? Well, it's not officially prescribed for weight loss yet, though last I heard, Amylin is in phase III trials for a version of Byetta for obesity. However, some doctors out there (my best friend's, for one) is prescribing it for chronically obese patients. There is another drug on the horizon, Acomplia, a drug made specifically for people with addictive behaviors - both for food and smoking. Acomplia works by blocking the CB1 receptor, one of two receptors found in a newly described physiological system called the Endocannabinoid System (EC System), believed to play a critical role in the regulation of food intake and energy expenditure.
On the other hand, Byetta, a drug formulated specifically for the treatment of diabetes, works through several actions, including the stimulation of insulin secretion only when blood sugar is high and by restoring the first-phase insulin response, an activity of the insulin-producing cells in the pancreas that is lost in patients who have type 2 diabetes. As a "side effect", this action also makes the user feel fuller on much less food, and slows the digestive process, so they have that full feeling longer. Byetta is the first in a new class of drugs for the treatment of type 2 diabetes called incretin mimetics and exhibits many of the same effects as the human incretin hormone glucagon-like peptide-1. Basically, it mimics your body's natural response to blood sugar.
So there you have the two contenders. Acomplia works by blocking your ability to receive pleasure from an addictive activity, like smoking or eating. Byetta (when used for obesity), works by making you feel full sooner, and keeping that feeling longer.
In a recent study done on Acomplia in the US, 2/3s of the participants quit the study, even though they were losing weight. The researchers aren't sure why. My guess - and this is only a guess - is that people wanted to get a good feeling by eating, and when they didn't it they went off the drug. It would be akin to eating food without being able to taste it - more work than pleasure. Again, just speculation on my part.
As for Byetta, we don't know what the results of the phase III trials are yet. At least with Byetta, the food you do eat will be pleasurable - you just don't feel like eating much of it.
My money is on Byetta. Here's why: Byetta is mimicking what the body does naturally; if you eat too much food, you stop eating, and don't want to eat for quite a while (think Thanksgiving). Byetta seems to over-drive that response, so you have a Thanksgiving-size meal on 1/4 of what you used to eat, and you don't want to eat for a long time after. The resulting decrease in caloric intake indicates weight loss. On the other hand, Acomplia denies you the pleasure you do get from eating, which I believe you should have. There's a reason God made eating pleasurable - so we will sustain ourselves! When you shut that off, I'm speculating, that something deep inside you seeks to overcome that. I don't know that, I'm just guessing. As for smoking, or other addictive, non-natural behaviors, Acomplia might be appropriate.
Now, if I could just get my hands on Byetta!
Byetta has been showing great promise for the treatment of type 2 diabetics; I get letters all the time from people telling me how their once untameable sugar levels are now in the normal zone, how they feel much better,etc.
How is Byetta stacking up as a weight-loss drug? Well, it's not officially prescribed for weight loss yet, though last I heard, Amylin is in phase III trials for a version of Byetta for obesity. However, some doctors out there (my best friend's, for one) is prescribing it for chronically obese patients. There is another drug on the horizon, Acomplia, a drug made specifically for people with addictive behaviors - both for food and smoking. Acomplia works by blocking the CB1 receptor, one of two receptors found in a newly described physiological system called the Endocannabinoid System (EC System), believed to play a critical role in the regulation of food intake and energy expenditure.
On the other hand, Byetta, a drug formulated specifically for the treatment of diabetes, works through several actions, including the stimulation of insulin secretion only when blood sugar is high and by restoring the first-phase insulin response, an activity of the insulin-producing cells in the pancreas that is lost in patients who have type 2 diabetes. As a "side effect", this action also makes the user feel fuller on much less food, and slows the digestive process, so they have that full feeling longer. Byetta is the first in a new class of drugs for the treatment of type 2 diabetes called incretin mimetics and exhibits many of the same effects as the human incretin hormone glucagon-like peptide-1. Basically, it mimics your body's natural response to blood sugar.
So there you have the two contenders. Acomplia works by blocking your ability to receive pleasure from an addictive activity, like smoking or eating. Byetta (when used for obesity), works by making you feel full sooner, and keeping that feeling longer.
In a recent study done on Acomplia in the US, 2/3s of the participants quit the study, even though they were losing weight. The researchers aren't sure why. My guess - and this is only a guess - is that people wanted to get a good feeling by eating, and when they didn't it they went off the drug. It would be akin to eating food without being able to taste it - more work than pleasure. Again, just speculation on my part.
As for Byetta, we don't know what the results of the phase III trials are yet. At least with Byetta, the food you do eat will be pleasurable - you just don't feel like eating much of it.
My money is on Byetta. Here's why: Byetta is mimicking what the body does naturally; if you eat too much food, you stop eating, and don't want to eat for quite a while (think Thanksgiving). Byetta seems to over-drive that response, so you have a Thanksgiving-size meal on 1/4 of what you used to eat, and you don't want to eat for a long time after. The resulting decrease in caloric intake indicates weight loss. On the other hand, Acomplia denies you the pleasure you do get from eating, which I believe you should have. There's a reason God made eating pleasurable - so we will sustain ourselves! When you shut that off, I'm speculating, that something deep inside you seeks to overcome that. I don't know that, I'm just guessing. As for smoking, or other addictive, non-natural behaviors, Acomplia might be appropriate.
Now, if I could just get my hands on Byetta!
Can Byetta help with PCOS?
Some doctors are trying it.
More and more, I have been coming across reports of ladies having Byetta prescribed for the treatment of PCOS - Polycystic Ovarian Syndrome. PCOS is a hormonal imbalance linked to the way the body processes insulin after it has been produced by the pancreas to regulate blood sugar (glucose).
I've added a section to our forum just for this emerging field of use.
More and more, I have been coming across reports of ladies having Byetta prescribed for the treatment of PCOS - Polycystic Ovarian Syndrome. PCOS is a hormonal imbalance linked to the way the body processes insulin after it has been produced by the pancreas to regulate blood sugar (glucose).
I've added a section to our forum just for this emerging field of use.
Once weekly Byetta study started.
Byetta injection just once a week?
This just in: Amylin has started a clinical trial for Exenatide LAR (Long-Acting Release) drug for type 2 diabetics. Safety and efficacy is being studied so that they have data to present for a New Drug Application to the FDA.
The study will involve 300 type 2 diabetics, split into two groups. One group gets the Exenatide LAR, the other gets the standard 10mcg dose of Byetta. Efficacy will be determined after 30 weeks of trials.
If all goes well, soon Byetta will only need to be taken once a week!
This just in: Amylin has started a clinical trial for Exenatide LAR (Long-Acting Release) drug for type 2 diabetics. Safety and efficacy is being studied so that they have data to present for a New Drug Application to the FDA.
The study will involve 300 type 2 diabetics, split into two groups. One group gets the Exenatide LAR, the other gets the standard 10mcg dose of Byetta. Efficacy will be determined after 30 weeks of trials.
If all goes well, soon Byetta will only need to be taken once a week!
How Does Byetta Work?
It actually does several things...
Normally, after you eat, your pancreas releases insulin to help your body store excess sugar for later use. This process occurs during normal digestion of food. In type 2 diabetes, your body does not work properly to store the excess sugar and the sugar remains in your bloodstream. Chronic high blood sugar can lead to serious health problems in the future. Proper diet is the first step in managing type 2 diabetes but often medicines are needed to help your body. Exenatide helps your body cope with high blood sugar in several ways. Exenatide helps the cells in the pancreas that produce insulin when there is too much sugar in your blood. Exenatide helps the cells of your liver to decrease the amount of sugar the liver dumps into your blood. Exenatide slows down the passage of food from your stomach and helps to decrease the amount of sugar added to your blood after eating. Exenatide also reduces the amount of food needed because the sugar in the bloodstream is processed more effectively.
Normally, after you eat, your pancreas releases insulin to help your body store excess sugar for later use. This process occurs during normal digestion of food. In type 2 diabetes, your body does not work properly to store the excess sugar and the sugar remains in your bloodstream. Chronic high blood sugar can lead to serious health problems in the future. Proper diet is the first step in managing type 2 diabetes but often medicines are needed to help your body. Exenatide helps your body cope with high blood sugar in several ways. Exenatide helps the cells in the pancreas that produce insulin when there is too much sugar in your blood. Exenatide helps the cells of your liver to decrease the amount of sugar the liver dumps into your blood. Exenatide slows down the passage of food from your stomach and helps to decrease the amount of sugar added to your blood after eating. Exenatide also reduces the amount of food needed because the sugar in the bloodstream is processed more effectively.
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